Faculty Bibliography

BACKGROUND: Rough-surface implants have become very popular during the last 10 years due to greater reported bone-implant-contact and bone volume between implant threads compared to machined-surface implants. PURPOSE: The aim of this clinical report is to present the 26-year clinical outcomes of machined-surface implants supporting screw-retained fixed dental prostheses in a 77-year-old woman. A 51-year-old woman received five mandibular and six maxillary implants supporting screw-retained fixed dental prostheses. The original machined-surface regular platform Branemark implants were placed using a two-stage surgical approach. MATERIALS AND METHODS: No implants were lost, and average marginal bone levels between the implant platform and the first bone-implant contact for maxillary and mandibular implants were 3.3 +/- 0.6 mm and 1.7 +/- 0.3 mm after 26 years. The following prosthetic complications were recorded during the follow up period; a) broken acrylic denture tooth (four times), b) loose prosthetic screw (three times), c) loose abutment screw (two times). CONCLUSION: This case report shows that machined-surface dental implants can successfully support screw-retained fixed dental prostheses over 26 years, which makes dental implants an important dental treatment option compared to the traditional prosthetic treatment methods, especially in elderly edentulous patients.

BACKGROUND: Although many factors seem to have an impact on the resonance frequency (RF) values of implants, there is a lack of evidence about some other parameters, which may have an influence on implant stability. PURPOSE: The aims of the study were to determine whether initial stability of a dental implant differs when the buccolingual width of the bone changes, to determine whether different orientations affect the RF measurements in the RF device, and to investigate two dental implants with different morphologies with regard to their initial stability. MATERIALS AND METHODS: Two implant systems (Tidal Spiral Dental Implant Systems, Huntsville, AL, USA, and MIS Seven, MIS Implants Technologies Ltd., Shlomi, Israel) with diameters of 3.75 mm and 4.2 mm and with a length of 13 mm were used. Following the insertion of implants, buccolingual thinning of the models was performed in 2-mm increments ranging between 0 and 8 mm. RESULTS: A statistically significant decrease for implant stability quotient (ISQ) values was noticed for both diameters and both systems for all dimensional time points of the blocks (p < .05). The second system (more number of threads) resulted with higher ISQ values for both diameters than the first system (lower number of threads) (p < .001). The orientation of the probe influenced the measurements, where a standard orientation is advisable for the magnetic RF device. CONCLUSION: Different implant surface geometries seem to behave in different patterns in terms of initial stability. Dimensional changes in buccolingual direction seem to have an impact on the initial stability, where wider implants also presented higher ISQ values than narrow ones.

PURPOSE: Diabetes mellitus is a prevalent medical disorder. It is often accompanied with systemic adverse sequelae, such as wound healing alterations, which may affect osseointegration of dental implants. The use of dental implants in patients with diabetes mellitus remains controversial because altered bone healing around implants has been reported. The purpose of this study was to present 1-year clinical outcomes of 23 implants placed in 10 patients with well-, or moderately well, controlled type 2 diabetes mellitus. MATERIALS: All implants were uneventfully placed in the mandible or maxilla. Three different types of definitive implant-supported prostheses, cement- or screw-retained fixed dental prostheses, and overdentures were delivered to the patients. RESULTS: At 1-year follow-up recall, no implants were lost, and 0.3 +/- 0.2 mm marginal bone loss was noted. No periapical radiolucencies, no bleeding on probing, or pathologic probing depth were recorded at these recalls. CONCLUSION: This clinical report supports the use of dental implants in patients with well-, or moderately well, controlled type 2 diabetes mellitus as a dental treatment modality. No evidence of diminished clinical success or significant complication related to implant treatment was found for this patient population.

PURPOSE: Alveolar ridge reduction, which is needed to create sufficient room for abutments, metal framework, and acrylic teeth, and a flat bone platform using commonly used burs is a time-consuming procedure and may cause discomfort to the patient. The aim of this study was to describe an alternative technique to fabricate a mandibular hybrid denture in 4 days without making any final impression and to describe the use of a reciprocating saw for alveolar ridge reduction. PATIENTS AND METHODS: Ten patients aged 45 to 75 years were considered for this study. Each patient received 5 implants for the reconstruction of the edentulous mandible after alveolar ridge reduction using a reciprocating saw or burs after the extraction of infected teeth. These implants were placed in the anterior region of the edentulous mandible and restored with final mandibular hybrid prosthesis in 4 days using the Ohio State University acrylic frame requiring no final impression procedure. RESULTS: No implants were lost, no technical complications were observed, and only minor marginal bone loss was noted after a year. The overall alveolar ridge reduction using a reciprocating saw after extraction of teeth took fewer than 2 minutes in the 5 patients, whereas a similar reduction took 34 +/- 12 minutes (20 to 50) with commonly used burs (round, fissure, or acrylic) in the other 5 patients. CONCLUSION: This study indicates that use of a reciprocating saw is a rapid and efficient method for alveolar ridge reduction in the anterior mandible, and the Ohio State University acrylic frame may be an alternative method to restore any edentulous mandible with an immediate-load mandibular hybrid denture.

BACKGROUND AND PURPOSE: Because of poor retention of complete removable dentures for edentulous patients, implant-supported mandibular overdentures have lately become a popular alternative for them. The aims of this prospective study were to evaluate treatment outcomes of mandibular overdentures supported by two unsplinted early-loaded implants and compare these results with those for delayed-loaded implants. MATERIALS AND METHODS: A total of 26 edentulous patients were treated with two unsplinted implants supporting a mandibular overdenture. All implants were placed in the canine regions of each mandible according to the one-stage surgical protocol. There were two groups: test group, in which the overdenture was connected 1 week after surgery, and control group, in which the overdenture was connected 3 months after surgery. Standardized clinical and radiographic parameters were recorded at surgery, and after 3, 6, 12, and 18 months, and 2, 3, 4, and 5 years. RESULTS: No implants were lost, and 0.93 +/- 0.3 mm marginal bone resorption was noted for all implants after 5 years. Clinical implant stability measurements, clinical peri-implant parameters, and marginal bone resorptions showed no statistically significant differences between the two groups over 5 years. CONCLUSION: The results of this prospective clinical study suggest that there is no significant difference in the clinical and radiographic state of patients treated with implant supported mandibular overdentures loaded either 1 week or 3 months after surgery.

The use of a removable partial denture (RPD) in clinical practice remains a viable treatment modality. Various advancements have improved the quality of a RPD, subsequently improving the quality of life for the individuals that use them. This article describes four removable partial denture treatment modalities that provide valuable treatment for the partially edentulous patient. These modalities include: the implant supported RPD, attachment use in RPDs, rotational path RPDs, and Titanium and CAD/CAM RPDs. Data on future needs for RPDs indicate that while there is a decline in tooth loss in the U.S., the need for RPDs will actually increase as the population increases and ages. With the growth in the geriatric population, which includes a high percentage of partially edentulous patients, the use of RPDs in clinical treatment will continue to be predictable treatment option in clinical dentistry.

BACKGROUND: Nowadays, there is some speculation among dental educators that the need for complete dentures will significantly decrease in the future and that training in their provision should be removed from the dental curriculum. OBJECTIVE: To sensitise the reader to the functional shortcomings of complete denture therapy in the edentulous patient and present restorative options including implants to improve edentulous quality of life in these patients. METHODS: Information retrieval followed a systematic approach using PubMed. English articles published from 1964 to 2008, in which the masticatory performance of patients with implant-supported dentures was assessed by objective methods and compared with performance with conventional dentures, were included. RESULTS: National epidemiological survey data suggested that the adult population in need of one or two complete dentures will increase from 35.4 million adults in 2000 to 37.9 million adults in 2020. Clinical studies have showed that the ratings of general satisfaction were significantly better in the patients treated with implant overdentures post-delivery compared with the complete denture users. In addition, the implant group gave significantly higher ratings on comfort, stability and ability to chew. Furthermore, patients who received mandibular implant overdentures had significantly fewer oral health-related quality of life problems than did the conventional group. CONCLUSION: Implant-supported dentures including either complete overdentures or a hybrid prosthesis significantly improve the quality of life for edentulous patients compared with conventional removable complete dentures. Therefore, the contemporary dental practitioner should consider other options as well as conventional removable complete dentures to restore edentulous patients.

AIM: The aim of the documentation of this clinical case is to make clinicians aware of "meth mouth" and the medical risks associated with this serious condition. BACKGROUND: Methamphetamine is a very addictive, powerful stimulant that increases wakefulness and physical activity and can produce other effects such as cardiac dysrhythmias, hypertension, hallucinations, and violent behavior. Dental patients abusing methamphetamine can present with poor oral hygiene, xerostomia, rampant caries ("meth mouth"), and excessive tooth wear. Oral rehabilitation of patients using methamphetamine can be challenging. CASE DESCRIPTION: A 30-year-old Caucasian woman presented with dental pain, bad breath, and self-reported poor esthetics. A comprehensive examination including her medical history, panoramic radiograph, and intraoral examination revealed 19 carious lesions, which is not very common for a healthy adult. She reported her use of methamphetamine for five years and had not experienced any major carious episodes before she started using the drug. SUMMARY: The patient's medical and dental histories along with radiographic and clinical findings lead to a diagnosis of "meth mouth." Although three different dental treatment modalities (either conventional or implant-supported) have been offered to the patient since August 2007, the patient has yet to initiate any treatment. CLINICAL SIGNIFICANCE: This clinical case showing oral manifestations of meth mouth was presented to help dental practitioners recognize and manage patients who may be abusing methamphetamines. Dental practitioners also may be skeptical about the reliability of appointment keeping by these patients, as they frequently miss their appointments without reasonable justification.